Hospitalization frequency and charges for neurocysticercosis, United States, 2003-2012

Abstract

Neurocysticercosis, brain infection with Taenia solium larval cysts, causes substantial neurologic illness around the world. To assess the effect of neurocysticercosis in the United States, we reviewed hospitalization discharge data in the Nationwide Inpatient Sample for 2003-2012 and found an estimated 18,584 hospitalizations for neurocysticercosis and associated hospital charges totaling >US $908 million. The risk for hospitalization was highest among Hispanics (2.5/100,000 population), a rate 35 times higher than that for the non-Hispanic white population. Nearly three-quarters of all hospitalized patients with neurocysticercosis were Hispanic. Male sex and age 20-44 years also incurred increased risk. In addition, hospitalizations and associated charges related to cysticercosis far exceeded those for malaria and were greater than for those for all other neglected tropical diseases combined. Neurocysticercosis is an increasing public health concern in the United States, especially among Hispanics, and costs the US health care system a substantial amount of money.

Keywords: Neurocysticercosis; Taenia solium; brain disease; central nervous system diseases; cestode infection; cysticercosis; economic burden; epilepsy; helminthiasis; neglected tropical disease; parasites; parasitic disease.

Figure 1

The lifecycle of the Taenia solium cestode parasite.

Figure 2

Frequency and total charges of hospitalizations in the United States during 2003–2012 for 13 of the World Health Organization (WHO)–designated neglected tropical diseases (NTDs) and malaria. Estimates were determined by using the Nationwide Inpatient Sample, which codes diagnoses according to the International Classification of Diseases, 9th Revision, Clinical Modification. Frequency of and total charges for hospitalizations for the other NTDs (i.e., Buruli ulcer, rabies, African trypanomiasis, and dracunculiasis) are not shown because there were too few hospitalizations for these diseases for accurate estimation. Frequency and total charges of hospitalizations for malaria, although it is not one of the WHO–designated NTDs, are shown for comparison.